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在服务不足的种族和族裔人群中,过敏和免疫状况的健康差异:美国过敏、哮喘和免疫学会委员会关于服务不足人群的工作组报告。

Health disparities in allergic and immunologic conditions in racial and ethnic underserved populations: A Work Group Report of the AAAAI Committee on the Underserved.

机构信息

Baylor College of Medicine, Houston, Tex; Texas Children's Hospital Food Allergy Program, Texas Children's Hospital, Houston, Tex.

Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pa.

出版信息

J Allergy Clin Immunol. 2021 May;147(5):1579-1593. doi: 10.1016/j.jaci.2021.02.034. Epub 2021 Mar 10.

Abstract

Health disparities are health differences linked with economic, social, and environmental disadvantage. They adversely affect groups that have systematically experienced greater social or economic obstacles to health. Renewed efforts are needed to reduced health disparities in the United States, highlighted by the disparate impact on racial minorities during the coronavirus pandemic. Institutional or systemic patterns of racism are promoted and legitimated through accepted societal standards, and organizational processes within the field of medicine, and contribute to health disparities. Herein, we review current evidence regarding health disparities in allergic rhinitis, asthma, atopic dermatitis, food allergy, drug allergy, and primary immune deficiency disease in racial and ethnic underserved populations. Best practices to address these disparities involve addressing social determinants of health and adopting policies to improve access to specialty care and treatment for the underserved through telemedicine and community partnerships, cross-cultural provider training to reduce implicit bias, inclusion of underserved patients in research, implementation of culturally competent patient education, and recruitment and training of health care providers from underserved communities. Addressing health disparities requires a multilevel approach involving patients, health providers, local agencies, professional societies, and national governmental agencies.

摘要

健康差异是指与经济、社会和环境劣势相关的健康差异。它们对那些在健康方面一直面临更大的社会或经济障碍的群体产生不利影响。美国需要重新努力减少健康差异,在冠状病毒大流行期间,少数族裔受到的不同影响尤为突出。机构或系统性的种族主义模式通过被社会认可的标准、医学领域内的组织流程得到推广和合法化,并导致健康差异。在此,我们回顾了在种族和民族服务不足人群中过敏性鼻炎、哮喘、特应性皮炎、食物过敏、药物过敏和原发性免疫缺陷病方面的健康差异的现有证据。解决这些差异的最佳实践包括解决健康的社会决定因素,并通过远程医疗和社区伙伴关系、改善服务不足人群获得专业护理和治疗的政策、减少隐性偏见的跨文化提供者培训、让服务不足的患者参与研究、实施文化上适宜的患者教育以及从服务不足的社区招聘和培训医疗保健提供者来解决这些差异。解决健康差异需要多层面的方法,涉及患者、医疗服务提供者、地方机构、专业协会和国家政府机构。

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